Depression is usually associated with adults. The thought of a child being depressed is something that seems unimaginable to parents and caregivers, as depression seems like something that develops as a result of not having the tools to cope with long periods of sadness and feelings of hopelessness.
Studies continue to show, however, that children of all ages can meet the criteria for a depression diagnosis if they have persistent symptoms of sadness that impact their ability to function in their academic, social, and family lives.
While depression and sadness are not synonymous, persistent sadness and the symptoms that come with it will determine if your child is experiencing a depressive episode instead of a typical bout of sadness.
Sadness looks different for everyone. For some, they will cry a lot and have difficulty stopping. Others may seem withdrawn and refuse to do things they used to enjoy doing. Some may become irritable and engage in angry outbursts and tantrum behavior.
Self-deprecating statements and being extremely hard on themselves is another possible expression of sadness. Some even express their sadness in the form of physical pain like headaches, stomach aches, or complaints of other illness.
Let’s discuss how to know when your child’s behaviors are typical expressions of sadness and when they may be moving toward depression, which may need professional treatment.
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Sadness is a common emotion that children experience, for a variety of reasons. Sadness, like any emotion, has been maintained throughout the evolutionary history of human beings for a reason.
Psychologists and researchers have long looked into the functions of our various negative emotions and have found that each one serves a purpose of either protection, learning, or growth.
Sadness, for example, is said to help people develop the ability to discern what is acceptable and unacceptable to them, to motivate someone to change the circumstances creating their sadness, to improve their ability to communicate their needs, and to learn and develop better judgment and awareness in life.
Sadness even helps people develop creativity.These are all skills that parents want their children to develop, but seeing our kids sad is difficult. We all want to be happy and emotionally healthy, and we want this even more for our children.
Then, our inclination is to alleviate our children’s sad feelings any way we can. Sometimes, the better strategy is actually to help them work through their sadness instead of around it.
But what sad feelings should a child be able to work through on their own (or with the help of a parent), and what sad feelings are more persistent and problematic, that may require the help of a professional?
The following symptoms of sadness are considered developmentally appropriate for children:
**Note: While these are considered typical patterns of behavior in children, using the tips in the “How Can I Help My Child?” section below can help to improve their ability to express their sadness appropriately.
The following is a list of depressive behaviors — they’re more persistent and affect a child’s overall functioning. If your child has experienced some, or all, of these symptoms for longer than two weeks, you may benefit from speaking with a mental health professional to determine if your child has depression and to get them help:
**Note: If you are noticing or experiencing these symptoms with your child, it is recommended that you seek assistance from a mental health professional to help improve their ability to cope with symptoms of depression.
Thanks to hormones and other biological developments, teenagers often experience a rush of emotions and the behaviors that come with them throughout these critical developing years.
It is common for teenagers to be labeled as moody or emotionally dysregulated, as they are learning how to work through their negative emotions without as much hand-holding from parents.
As a result, expression of sadness may seem more common for this age group, but it is increasingly important to monitor — extreme levels of sadness in teens and tweens can have dangerous consequences.
Determine between brief periods of sadness and more serious symptoms of depression by considering the duration and severity of the symptoms.
Just like with children, any behavior that occurs for less than two weeks and does not seem to affect their overall functioning in school, socializing, or home life is likely a typical period of sadness. Let’s discuss the more typical expressions of sadness for teens:
**Note: While these are considered typical patterns of behavior in teens, using the tips in the “How Can I Help My Child?” section below can help to improve their ability to express their sadness appropriately.
The following is a list of depressive behavior that teen’s exhibit that suggests they need professional help to learn how to manage and improve their overall functioning:
**Note: If you are noticing or experiencing these symptoms with your teen, it is recommended that you seek out assistance from a mental health professional to help improve their ability to cope with their symptoms of depression.
Unfortunately, unlike a lot of behaviors and conditions, it is unclear what contributes to someone developing depression.
Researchers believe that a combination of genetics and environment can increase the likelihood that a child or teen will become depressed.
While genetics are a large part, a learned pattern of thinking can also contribute to a child’s development of depression symptoms.
Negative and pessimistic thought patterns can increase the chance that a child or adolescent begins to see the world in a strictly negative light.
From these thoughts, hopelessness can settle into their minds, making it difficult for them to shake off their feelings of sadness or worthlessness.
General feelings of sadness or disappointment can linger in a person’s mind, and if it is not redirected it can cause a person to develop a pattern of depressive thinking.
Following are some common coinciding events that can contribute to negative thinking patterns and may exacerbate depressive responses in children and teens:
Children who live in high-conflict homes can experience emotional dysregulation that can present in withdrawn, isolative, and sad ways. Others may engage in externalizing behavior like anger, risky behavior, or tantrums to express their inner deep feelings of sadness about their home life.
Often children and teens who lean more toward internalizing their discomfort may not be able to share or identify their feelings due to fear, embarrassment, or shame in a high-conflict home, and the continued internalizing can cause a child to bottle up their feelings and develop more chronic, long-lasting difficulties later in life.
It is not uncommon now to see that even very young children are developing severe depression symptoms as a result of not feeling like they fit in with their peers. In recent years, multiple children, as young as eight years old, have committed suicide as a result of bullying, taunting, and social ridicule and isolation.
In addition to those being bullied, it is also common for the bullies themselves to actually be struggling with mental health issues, depression included. Depending on whether a person’s inclination is to internalize or externalize their emotional struggles can determine which way they sway.
Either way, however, depression can and does result from consistent patterns of feeling disconnected from a social group and can get worse when there is aggressive harassment and victimization taking place.
While much less common, it is possible that some children may have a medical condition that could be impacting their ability to regulate their emotions; occasionally children experience neurological impairments or other medical diagnoses that can account for changes in mood and inability to manage their depressive thoughts, feelings, and behaviors.
Beginning to understand the symptoms of depression is the first step to helping your child improve overall functioning, so you are in the right place.
Once you have determined that your child is experiencing symptoms that seem consistent with depression, the most important thing is to connect with a professional who can help them learn tools to improve their thought process, which will, in turn, help them feel better.
In addition to getting professional help from a mental health clinician, here are some parenting strategies to implement at home:
Children often don’t understand their own feelings and cannot connect their behavior to how they’re feeling internally. Parents notice changes in their child’s behavior first and can begin to separate between what is typical and atypical for their child.
If you begin to notice that your child is beginning to have much more atypical behavior than you are used to seeing, monitoring and documenting the symptoms and having a good idea of what has changed will help you to communicate both with your child and with a professional about is happening in your child’s life.
I often explain this to families I work with by saying, “No feeling is final,” meaning that we are never in one emotional state for too long before another comes up. Situations in our life will evoke all kinds of emotions —positive and negative — and no one gets stuck in any one emotion forever.
Sadness is a feeling that is uncomfortable and can be distressing, but it is healthy and necessary for people to learn and grow.
Being able to acknowledge when your child is feeling sad, and also express that it is okay for them to be sad can help them avoid internalizing negative emotions, which ultimately leads to them bottling up feelings for so long that they explode.
While a child will learn about and develop coping skills when participating in treatment with a mental health professional, as they go through their life day to day, they often forget the appropriate times to use them.
Parents can continually remind them about important coping skills like deep breathing, meditation/relaxation practices, listening to music, using “I” statements to get their needs met, challenging their thoughts and gathering evidence for positive alternatives, and many more.
When kids are feeling depressed, it is hard for them to want to do anything, which can make it very difficult to stick to a routine. But routines and getting kids active and engaged in the world is one of the best ways to fight depression symptoms.
This doesn’t mean parents should force their kids to run a couple miles every day or clean the whole house with a tooth brush, but making sure that a child is completing daily tasks and moving their body is important.
Light chores and completing tasks can help to keep them busy and can also help a person feel more productive and successful.
In addition to tasks throughout the day, getting them to move their bodies is an important way to improve their mood and behavior.
Something small like stretching or going on a walk can do wonders to improve the functioning of the brain by getting the blood pumping in a different way than when they are sedentary.
While depression is a condition that can be overwhelming for children and scary for their parents, it is important to focus on being both nurturing and accepting of where your child is in terms of their depression symptoms, but also to remain firm and continue to encourage them to participate in life actively.
This means connecting with them and acknowledging their feelings, but reminding them about their responsibilities (homework, going to school, doing chores, etc.) and ensuring that they followed through.
Depression symptoms can be exacerbated by long periods of retreat from responsibilities and will also train children to see their depressive symptoms as something they can give up on rather than fight through.
Children learn most things from their parents, particularly the way parents handle negative experiences. It is important to remember that your ability to manage your own emotions and responsibilities in front of your children will help them to learn the best way to do it themselves.
This means being vulnerable at times and modeling that it is okay to cry, it is okay to need some time alone, but that continuing to do daily tasks and nurture your body with both healthy food and exercise is important to maintaining a high level of functioning.
Depressive symptoms are varied in their presentation and children in particular can have many different ways they show their symptoms and recovery. It is important to remember that moodiness and sadness is a healthy part of life and, as long as it is being monitored, children will not remain in this state forever.
That being said, children and teens who experience depressive symptoms generally need the help of a professional to provide them with the psychoeducation needed to develop tools to change mood and improve behavior.
If they do not get this help, they may be able to improve on their own, but it may take longer and can increase the chance that they are developing long-term patterns that will be more difficult to redirect as they age.
Depression is obviously a medical condition that mental health professionals have developed expertise in understanding and treating. Professionals who work with children have the unique skill set of being able to help children and parents understand the symptoms and how to manage and overcome them. -Sadness is usually situational and short-lived while depression may wax and wane but persist over the course of a lifetime.
While there are many different approaches to manage symptoms of depression, cognitive behavioral therapy (CBT) is a well-researched approach that most professionals will use with children to help them understand the connection between how they think, feel, and behave.
Often this can be done one-on-one with a therapist and child or in a family setting so that the family can learn skills to set the child up for success.
If severe enough, a child may be prescribed medication in addition to therapeutic treatment to improve their ability to absorb and use coping skills, though this is not always recommended or necessary in every case. However, since depression is a medical condition related to low levels of neurotransmitters such as serotonin and dopamine, medication may be the only way to successfully manage the condition long term in conjunction with psychotherapy.
A therapist will often do an assessment of symptoms and child functioning and can make recommendations that a family see a psychiatrist or their general practitioner to determine if medication would be helpful for them.
While depression can seem overwhelming, there are many people in the mental health field who dedicate their lives to helping children and families tackle it before it becomes severe.
Finding the right person can help you to feel confident that you are doing all you can to help your child be the best that they can be!